The Middleman's Cut: Steve Ditto on Who Really Profits in Healthcare
Who is really looking out for employers and patients when it comes to healthcare costs? Author Steve Ditto unpacks the role middlemen play in driving costs up.

About this episode
Chris Estep and Andy Rodriguez sit down with healthcare expert and author Steve Ditto to discuss his book, The Middleman's Cut, and the often overlooked role middlemen play in driving healthcare costs.
Steve shares his personal experience navigating the healthcare system and explains why employers need to take a closer look at their pharmacy benefit manager contracts, understand their fiduciary responsibilities, and demand more transparency and accountability from their healthcare partners.
The conversation covers the value of working with unconflicted advisors, the hidden complexity inside healthcare agreements, and how Steve's Contract X-Ray tool helps employers spot problematic contract terms before they sign.
You don't need all the answers, but you do need visibility.
Topics covered
- The role middlemen play in healthcare costs
- Why employers should scrutinize PBM contracts
- Fiduciary responsibility for plan sponsors
- Working with unconflicted advisors
- Using Contract X-Ray to find problem contract terms
Steve Ditto
Healthcare expert and author of The Middleman's Cut
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